The use of group work and journal writing in reinventing development planning for sustainability under complexity

Since 2002 Stellenbosch has offered a multidisciplinary Masters programme in Planning, Management and Practice of Sustainable Development (with a specialisation in development planning), offered mainly for working adult students. One of the challenges of developing a curriculum for this degree is that sustainable development (SD) and ‘development planning’, the focal points of the programme, are potentially very broad concepts, requiring the exploration of a variety of complex challenges in the African context, moving beyond the traditional spatial focus of planning in South Africa. This article explores the various potential meanings of SD, as well as its link with complexity thinking, systems thinking and complex adaptive systems and its implications for planning education and curriculum development. Complex adaptive systems thrive on diversity, creativity, and innovation. The programme is not about spoon-feeding, but about allowing space to explore and discover for oneself the diverse interpretations, tensions and contradictions inherent in planning, development and sustainability. Most concepts (participation, sustainability, planning, development, and so on) have a whole continuum of possible meanings between polar opposites, and it is important to make students aware of the language games people play in order to enable them to move beyond the clichés, myths and spin. Self-managed learning is an important element of this programme and innovative methods have to be found to teach the basics (to kick-start the learning) and create the pre-conditions for lifelong learning, as well as instil the critical, questioning, and imaginative attitude needed to invent the sustainable future we need. In addition to formal lectures and discussion classes, writing skill workshops to teach the important skill of writing, two of the more innovative teaching techniques used to try and bridge the teaching divide are journal writing and group work. In the real world, actor collaboration and group processes are very important methods of building knowledge. Since SD does not have a fixed meaning and is value-laden and multi- (or trans-) disciplinary, it requires democratic and deliberative public processes to give meaning to the concept. For this reason, group work forms an important element of the teaching curriculum and students are required to give feedback on the group process after each exercise and in their journals. The purpose of the journal writing is also to try to stimulate deep, rather than superficial learning and to help make the linkages in support of transdisciplinary learning, where learners are taught to make connections between social, political, economic, biological and physical dimensions and to make use of more holistic ways of thinking. Journal writing and reflections on group work have demonstrated many learning benefits, but also the need for more structure and guidance to steer individual learning processes

Sustainability and sustainable development as the making of connections : lessons for integrated development planning in South Africa

CITATION: Muller, A. 2006. Sustainability and Sustainable Development as the making of Connections: Lessons for Integrated Development Planning in South Africa. In Cullinan, M., Madell, C. & Watson, V. (eds). Proceedings of the Planning Africa 2006 Conference. www.saplanners.org.za. ISBN 0-620-36402-5. 1210 pages.ENGLISH SUMMARY : Africa’s many developmental problems (poverty and environmental degradation) have to be solved in a sustainable way. However, the complex, multi-dimensional concepts of ‘sustainability’ and ‘sustainable development’ (SD) can be interpreted in different and even clashing ways by various interest groups and are often used as ‘spin’ or buzzwords. The many potential meanings include SD as a process or end point/ goal, SD as inter-generational, intra-generational or inter-species equity, SD as separate ecologically or socially sustainable development or as holistic/ integrated economic, social, ecological, institutional, technological and physical development, SD as conservation (the Green Agenda), SD as development (the Brown Agenda); SD as Human Rights (the Red Agenda); SD as Human Development and as democracy/participative development. Even when a certain meaning of SD is promoted (such as for instance SD as inter-generational equity or SD as integration as in many South African policy documents), the practical application of the concept rarely conforms to the meaning that is promoted. One of the conceptions of sustainable development that has the greatest potential for future development in Africa, is that of a collaborative, communicative learning process of ‘making connections’ and linkages between various role-players -experts, disciplines (transdisciplinarity), communities; formal and informal businesses, politicians, officials and civil society (NGOs, CBOs) at local level. ‘Integrated Development Planning’ can potentially play a role in ‘making connections’ and in the construction of local meaning regarding SD. A recent study of completed IDP documents, however, showed a very simplistic and superficial understanding of the concepts of sustainability and SD. These plans also illustrated a lack of knowledge about the theory regarding communicative or collaborative planning and did not try to deal with the underlying conflict regarding the meaning of ‘development’ and therefore were little more than ‘lowest common denominator’ plans. This paper will analyse the meanings given to the concept of SD in IDP documents and from this will recommend some lessons for future planning.Post prin

The predictive value of Grade 12 and university access tests results for success in higher education

Thesis (MEd)--Stellenbosch University, 2013.BibliographyENGLISH ABSTRACT: The final school examination is the gateway to higher education (HE) in most countries. Many students are however ill-prepared for HE because of a lack of quality education. Internationally, alternative access programmes are offered to address this problem. SciMathUS is the Science and Mathematics bridging programme at Stellenbosch University with the aim to allow educationally disadvantaged students whose Grade 12 results are below the standard entrance scores for admittance to HE, a second chance to improve their scores in Mathematics and Physical Sciences and then reapply for HE. SciMathUS follows a hybrid Problem-based Learning (PBL) philosophy, encouraging students to take responsibility for their own learning. While it is expected that performance in the final school examination correlates with performance in HE, this is questioned in the case of students who do not have access to good education and, as a result thereof, leave school with poor to low results. With the high demand for HE internationally, identifying students with the potential to succeed is however a huge challenge. Alternative measurements have been and are being considered and researched. The focus of this quantitative research is to determine whether Grade 12 results (Mathematics and Physical Sciences) and Stellenbosch University Access Test (AT) results could predict success in HE for students who first attended a bridging programme. Success was defined quantitatively and measured by the results obtained at the end of their first year in HE. Quantitative techniques were used to analyse the possible relationships between the different variables. The findings were that SciMathUS students managed to improve their Grade 12 Mathematics and Physical Sciences and AT significantly after attending the bridging programme. These results allowed them to participate in HE. No correlation could, however, be found between their NSC results or the AT results and their performance in HE. In spite of this, more than 40% of the students in this group passed their first year in HE with an average of more than 50%. Another almost 40% obtained between 30% and 50% and were therefore allowed to continue with their studies. In three faculties at Stellenbosch University, the former bridging programme students performed on par with their peers from the same schools who enrolled in HE directly after school.AFRIKAANSE OPSOMMING: Die finale skooleksamen bied internasionaal toegang tot hoër onderwys. As gevolg van ʼn gebrek aan goeie skoolopleiding, is baie studente egter nie voldoende voorbereid vir hoër onderwysstudies nie. Om hierdie probleem aan te spreek, het alternatiewe toegangsprogramme ontstaan. SciMathUS is die Wiskunde- en Wetenskapoorbruggingsprogram by Stellenbosch Universiteit. Die program bied aan opvoedkundigbenadeelde studente, wie se Graad 12-punte nie voldoende is om toegang tot hoër onderwys te kry nie, ʼn tweede kans om hul punte in Wiskunde en Fisiese Wetenskappe te verbeter. Met hierdie nuwe uitslae kan hulle dan weer aansoek doen vir toelating. SciMathUS volg ʼn hibriede probleem-gebaseerde leerbenadering wat onder meer daarop gemik is om die studente aan te moedig om self verantwoordelikheid vir hul eie leer te aanvaar. Die verwagting is dat daar ʼn korrelasie sal bestaan tussen skooluitslae en prestasie in hoër onderwys. Dit word egter bevraagteken vir studente wat nie toegang tot goeie skoolopleiding gehad het nie en as gevolg daarvan swak presteer in die finale skooleksamen. Omdat meer studente tot hoër onderwys wil toetree, raak dit toenemend belangrik om die studente met potensiaal te kan identifiseer. Alternatiewe meetinstrumente word dus geruime tyd al oorweeg en nagevors. Dit is ook die fokus van hierdie kwantitatiewe studie: om te bepaal of Graad 12 uitslae (in Wiskunde en Fisiese Wetenskappe) en die uitslae van die toegangstoetse van die Universiteit van Stellenbosch gebruik kan word om sukses van studente wat eers die SciMathUS oorbruggingskursus bygewoon het, in hoër onderwys te kan voorspel. Vir hierdie studie word sukses kwantitatief gedefinieer en gemeet aan die student se gemiddelde persentasie wat aan die einde van hul eerstejaar in hoër onderwys behaal het. Statistiese analises is gebruik om die moontlike korrelasies tussen die verskillende veranderlikes te bepaal. Die bevindinge van hierdie studie is dat die SciMathUS-studente se Graad 12 Wiskunde en Fisiese Wetenskappe uitslae en toegangstoetsuitslae noemenswaardig verbeter het nadat hulle die program gevolg het. Hierdie uitslae het hulle toegelaat om toegang te kry tot hoër onderwys. Geen korrelasie is egter tussen die Nasionale Senior Sertifikaatuitslae of die toegangstoetsuitslae en prestasie in hoër onderwys gevind nie. Ten spyte daarvan het meer as 40% van die studente in die groep hul eerstejaar met ʼn gemiddelde persentasie van meer as 50% geslaag. Ongeveer nog 40% van die studente het tussen 30% en 50% behaal en is dus toegelaat om met hul studies te kon voortgaan. In drie fakulteite by Stellenbosch Universiteit het die voormalige brugprogramstudente net so goed gevaar soos die studente wat dieselfde skole as hulle bygewoon het maar direk na skool by Stellenbosch Universiteit ingeskryf het

Calprotectin instability may lead to undertreatment in children with IBD

BACKGROUND: Treatment decisions in children with inflammatory bowel disease (IBD) are increasingly based on longitudinal tracking of faecal calprotectin concentrations, but there is little known about the stability of this protein in stool. METHODS: We stored aliquots of homogenised stool at room temperature and at 4°C, and measured the calprotectin concentration for 6 consecutive days with three different assays. In addition, we assessed calprotectin stability in assay-specific extraction buffers kept at room temperature. RESULTS: After 6 days of storage at room temperature, mean percentage change from baseline calprotectin concentrations in stool and extraction buffer was 35% and 46%, respectively. The stability of calprotectin was significantly better preserved in samples stored at 4°C (p=0.0066 and 0.0011, respectively). CONCLUSIONS: Calprotectin is not stable at room temperature. Children with IBD and their caretakers may be falsely reassured by low calprotectin values. The best advisable standard for preanalytical calprotectin handling is refrigeration of the stool sample until delivery at the hospital laboratory

Adiposity Blunts the Positive Relationship of Thyrotropin with Proprotein Convertase Subtilisin-Kexin Type 9 Levels in Euthyroid Subjects

BACKGROUND: Effects of thyroid function status on lipoprotein metabolism may extend into the euthyroid range. Low-density lipoprotein (LDL) metabolism is governed by proprotein convertase subtilisin-kexin type 9 (PCSK9), which down-regulates LDL receptor expression, resulting in higher LDL cholesterol (LDL-C). Here, we tested whether plasma PCSK9 correlates with thyroid function in nonobese and obese euthyroid subjects. METHODS: We assessed the extent to which plasma PCSK9 is determined by thyrotropin (TSH) in 74 euthyroid subjects (31 women; TSH between 0.5 and 4.0 mU/L and free thyroxine [FT4] between 11.0 and 19.5 pM) with varying degrees of obesity (body mass index [BMI] ranging from 20.2 to 40.4 kg/m(2)). RESULTS: TSH, FT4, PCSK9, non–high-density lipoprotein cholesterol (non-HDL-C), LDL-C, and apolipoprotein B (apoB) levels were not different between 64 nonobese subjects (BMI<30 kg/m(2)) and 10 obese subjects (BMI≥30 kg/m(2); p>0.20 for each). PCSK9 correlated positively with TSH in nonobese subjects (r=0.285, p=0.023). In contrast, PCSK9 was not associated positively with TSH in obese subjects (r=−0.249, p=0.49). The relationship of PCSK9 with TSH was different between nonobese and obese subjects when taking age, sex, FT4, and the presence of anti-thyroid antibodies into account (multiple linear regression analysis: β=−0.320, p=0.012 for the interaction term between the presence of obesity and TSH on PCSK9), and was also modified by BMI as a continuous trait (β=−0.241, p=0.062 for the interaction term between BMI and TSH on PCSK9). Non-HDL-C, LDL-C, and apoB levels were dependent on PCSK9 in nonobese subjects (p≤0.01 for each), but not in obese subjects (p>0.50), Accordingly, BMI interacted negatively with PCSK9 on non-HDL-C (p=0.028) and apoB (p=0.071). CONCLUSIONS: This study suggests that circulating PCSK9 levels correlate with thyroid function even in the normal range. This relationship appears to be blunted by obesity. Thyroid functional status may influence cholesterol metabolism through the PCSK9 pathway

Macro-B12 masking B12 deficiency

In clinical practice, the finding of an elevated serum B(12) concentration is often the consequence of supplementation with B(12) in either oral form or injections. Also, elevated serum B(12) may be associated with underlying disorders, like liver diseases or a (haematologic) malignancy. Only a few studies have shown that it may also be the consequence of complex formation of B(12)-vitamin binding proteins with immunoglobulins, the so-called macro-B(12). We describe a young woman who previously was diagnosed with B(12) deficiency, and in whom, after cessation of B(12) injection treatment, neurologic symptoms re-appeared, and despite this, repeatedly elevated serum B(12) concentrations above the upper limit of the assay were found. We demonstrated that this was caused by the presence of macro-B(12), which not only resulted in erroneous and longstanding elevated serum B(12), but also masked her underlying B(12) deficiency

Regulatory T Cells Facilitate Thymic Recovery After HSCT by Directly Enhancing Immigration of Donor Derived Thymic Progenitors

BACKGROUND & AIMS: An increasing number of physicians use repeated measurements of stool calprotectin to monitor intestinal inflammation in patients with inflammatory bowel diseases (IBDs). A lateral flow-based rapid test allows patients to measure their own stool calprotectin values at home. The test comes with a software application (IBDoc; Buhlmann Laboratories AG, Schonenbuch, Switzerland) that turns a smartphone camera into a results reader. We compared results from this method with those from the hospital-based reader (Quantum Blue; Buhlmann Laboratories AG) and enzyme-linked immunosorbent assay (ELISA) analysis. METHODS: In a single-center comparison study, we asked 101 participants (10 years of age or older) in the Netherlands to perform the IBDoc measurement on stool samples collected at home, from June 2015 to October 2016. Participants then sent the residual extraction fluid and a fresh specimen from the same bowel movement to our pediatric and adult IBD center at the University Medical Center Groningen, where the level of calprotectin was measured by the Quantum Blue reader and ELISA analysis, respectively. The primary outcome was the agreement of results between IBDoc and the Quantum Blue and ELISA analyses, determined by Bland-Altman plot analysis. RESULTS: We received 152 IBDoc results, 138 samples of residual extraction fluid for Quantum Blue analysis, and 170 fresh stool samples for ELISA analysis. Spearman's rank correlation coefficient was 0.94 for results obtained by IBDoc vs Quantum Blue and 0.85 for results obtained by IBDoc vs ELISA. At the low range of calprotectin level (= 100 mu g/g), and 71% of IBDoc-ELISA results were in agreement. At the high range of calprotectin level (>= 500 mu g/g), 81% of IBDoc-Quantum Blue results were within the predefined limits of agreement (+/- 200 mu g/g) and 64% of IBDoc-ELISA results were in agreement. CONCLUSIONS: Measurements of fecal levels of calprotectin made with home-based lateral flow method were in agreement with measurements made by Quantum Blue and ELISA, as long as concentrations wer

Double venipuncture is not required for adequate S-100B determination in melanoma patients

S-100B is used in melanoma follow-up. This serum biomarker is also present in adipocytes; therefore, subcutaneous adipocytes trapped in the needle before performing a venipuncture could contaminate the serum. The aim was to study the influence of adipocyte contamination on blood samples used for S-100B analysis, possibly resulting in falsely elevated S-100B values. A total of 294 serum samples were collected from 147 American Joint Committee on Cancer staging stage III melanoma patients. The mean difference between the first (dummy) and second tubes was 0.003 μg/l (p = 0.077), with a decrease in the second tube. Compared with the second tube, the S-100B level was higher in the first tube in 33.3% of the samples, equal in 36.8% of the samples and lower in 29.9% of the samples. No significant difference between the two consecutively drawn tubes was found. There seems to be no necessity of implementing a dummy tube system for accurate S-100B determination in melanoma patients

Tumor markers in finding recurrent disease in colorectal cancer: a diagnostic review

Aim: In the search for evidence-based follow-up of patients after resection for colorectal cancer, numerous tumor markers have been proposed. This review has evaluated these markers and comments on the diagnostic accuracy in finding recurrent disease in relation to Carcino-Embryonic Antigen (CEA). Methods: A comprehensive literature review (1985-2010) was performed by two independent reviewers. Sensitivity and specificity of markers mentioned in the articles were checked by recalculation. A validated quality score system was used to estimate study quality. Results: Seventeen studies focusing on eight different markers were included. Three markers were shown to have comparable or better accuracy than CEA: TPA, CA 242 and CA 72-4 in at least one study. These three markers, from four independent studies, showed a tumor marker sensitivity of &gt; 60% in combination with an outperformance of CEA in follow-up. These results were not confirmed by six other studies investigating the same markers. Conclusion: This review revealed three tumor markers other than CEA that have been shown to adequately indicate recurrences in colorectal cancer. However, comparability of studies was difficult. Therefore a prospective study of these markers seems necessary to investigate their real value, and to overcome design and inclusion biases

Epidemiology of thyroid disorders in the Lifelines Cohort Study (the Netherlands)

Background Thyroid hormone plays a pivotal role in human metabolism. In epidemiologic studies, adequate registration of thyroid disorders is warranted. We examined the prevalence of thyroid disorders, reported thyroid medication use, thyroid hormone levels, and validity of thyroid data obtained from questionnaires in the Lifelines Cohort Study. Methods We evaluated baseline data of all 152180 subjects (aged 18-93 years) of the Lifelines Cohort Study. At baseline, participants were asked about previous thyroid surgery and current and previous thyroid hormone use. At follow-up (n = 136776, after median 43 months), incident thyroid disorders could be reported in an open, non-structured question. Data on baseline thyroid hormone measurements (TSH, FT4 and FT3) were available in a subset of 39935 participants. Results Of the 152180 participants, mean (+/- SD) age was 44.6 +/- 13.1 years and 58.5% were female. Thyroid medication was used by 4790 participants (3.1%); the majority (98.2%) used levothyroxine, and 88% were females. 59.3% of levothyroxine users had normal TSH levels. The prevalence of abnormal TSH levels in those not using thyroid medication was 10.8%; 9.4% had a mildly elevated (4.01-10.0 mIU/L), 0.7% had suppressed (10.0 mIU/L) TSH levels. Over 98% of subjects with TSH between 4 and 10 mIU/L had normal FT4. Open text questions allowing to report previous thyroid surgery and incident thyroid disorders proved not to be reliable and severely underestimated the true incidence and prevalence of thyroid disorders. Conclusions Undetected thyroid disorders were prevalent in the general population, whereas the prevalence of thyroid medication use was 3.1%. Less than 60% of individuals using levothyroxine had a normal TSH level. The large group of individuals with subclinical hypothyroidism (9.4%) offers an excellent possibility to prospectively follow the natural course of this disorder. Both structured questions as well as linking to G.P.'s and pharmacists' data are necessary to improve the completeness and reliability of Lifelines' data on thyroid disorders